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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Husband Retiring and Wife Needs Coverage

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Question: I am getting medical coverage from my husband’s work. He is going to retire and I am not at retirement age yet. As I understand, he will start getting medical coverage through Medicare. 1. What is going to happen to my med coverage? 2. What if I have “pre-existing conditions”?

Answer: When your husband retires, your family’s health insurance coverage will end. He will be covered by Medicare (if he is 65 years old or disabled). You will have to purchase your own health insurance and I understand you may not qualify for individual health insurance because you have preexisting medical conditions. If you are declined individual health coverage, you will qualify for guaranteed issue health insurance coverage under the federal HIPAA law. Most health insurance companies who market individual health insurance offer HIPAA qualified coverage. HIPAA plans are usually high deductible PPO plans at a substantial mark-up over the standard rate for a “healthy” applicant. The idea being that HIPAA applicants are a greater risk as a group. You may be able to purchase a HIPAA plan from your current insurer, but can shop for HIPAA plans from any other carrier in your state. A second option may be available - major-risk pool health insurance. Availability varies by state.

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